ArticleClinics (Sao Paulo, Brazil)2026
Early combination of terlipressin and norepinephrine in the treatment of patients with septic shock.
Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Efficacy of milrinone combined with norepinephrine in improving hemodynamics and protecting liver/kidney function in patients with septic shock.Pakistan journal of medical sciences · 2026Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study set out to determine whether early use of Terlipressin (TP) as an adjunct to Norepinephrine (NE) could improve clinical outcomes in patients with septic shock. MATERIAL AND
methodsIn this prospective, randomized trial, 104 patients with septic shock were assigned to three groups receiving TP at different NE thresholds: Low-dose (L, ≥ 0.25 μg/kg/min), Mid-dose (M, ≥ 0.5 μg/kg/min), and High-dose (H, ≥ 0.75 μg/kg/min). Primary outcomes included 28-day mortality and vasopressor-free days. Secondary outcomes encompassed hemodynamic parameters, organ function recovery, inflammatory markers, and adverse events.
resultsNo significant difference was observed in 28-day mortality among groups (L: 42.86 %, M: 47.06 %, H: 51.43 %; p = 0.328). However, the L group exhibited significantly more vasopressor-free days (defined as days alive and free of all vasopressor support for ≥ 24 consecutive hours within the first 7-days after randomization; median 4.2, IQR 2.1-5.3) than the M (3.1-days) and H groups (2.3-days; p < 0.01). Key secondary outcomes showed superior hemodynamic stabilization in the L group, with shorter time to target MAP (4.2 vs. 5.6-6.5 h, p < 0.05) and accelerated lactate clearance (p < 0.01). Organ function recovery was significantly enhanced in the L group, demonstrated by reduced CRRT duration (3.5 vs. 6.8-7.5 days, p < 0.001), improved renal and hepatic function, higher platelet counts (215 vs. 130-165 × 10⁹/L, p < 0.001), and more rapid inflammatory resolution (Procalcitonin and CRP reduction, all p < 0.05). Adverse events were significantly lower in the L group (p < 0.001).
conclusionsEarly low-dose TP adjunctive therapy reduces NE dependence, enhances hemodynamic stability, promotes multi-organ function recovery, and improves safety profile in septic shock, without significantly affecting 28-day mortality. These findings support its role as a beneficial adjunct vasopressor when initiated at lower NE doses.
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